Powered tacker instrument

ABSTRACT

There is provided a powered tacker device for use in installing multiple surgical fasteners through a prosthetic mesh into tissue. The powered tacker device generally includes a handle assembly and a tacker assembly extending distally from the handle assembly. The handle assembly includes a motor and self-contained power assembly to rotate the surgical fasteners into tissue. The handle assembly is provided with a drive assembly which allows for rotation, as well as distal longitudinal movement, of a surgical fastener relative to the powered tacker device. The tacker assembly includes an inner tube for containing the plurality of surgical fasteners and a driver which is movable out of alignment with the inner tube so as to install a single fastener at a time into tissue.

CROSS REFERENCE TO RELATED APPLICATION

The present application is a Continuation of, and claims the benefits ofand priority to U.S. patent application Ser. No. 11/801,507, now U.S.Pat. No. 7,931,660, which was filed on May 10, 2007. The entire contentsof which are incorporated herein by reference.

BACKGROUND

1. Technical Field

The present disclosure relates to a surgical instrument for installingfasteners into tissue. More particularly, the present disclosure relatesto a powered tacker instrument for use in applying surgical fastenersthrough a prosthetic mesh and into tissue during hernia repair surgery.

2. Background of Related Art

Various surgical procedures require instruments capable of applyingfasteners to tissue to form tissue connections or to secure objects totissue. For example, during hernia repair procedures it is oftendesirable to fasten a mesh to body tissue. In certain hernias, such asdirect or indirect inguinal hernias, a part of the intestine protrudesthrough a defect in the abdominal wall to form a hernial sac. The defectmay be repaired using an open surgery procedure in which a relativelylarge incision is made and the hernia is closed off outside theabdominal wall by suturing. The mesh is attached with sutures over theopening to provide reinforcement.

Less invasive surgical procedures are currently available to repair ahernia. For example, in laparoscopic procedures, the hernia repairsurgery is performed through a small incision in the abdomen while inendoscopic procedures, the hernia repair surgery is performed throughnarrow endoscopic tubes or cannulas inserted through small incisions inthe body. Laparoscopic and endoscopic procedures generally require theuse of long and narrow surgical instruments capable of reaching deepwithin the body and configured to seal with the incision or tube theyare inserted through. Additionally, the instruments must be capable ofbeing actuated remotely, that is, from outside the body.

Currently, endoscopic techniques for hernia repair utilize fasteners,such as, surgical staples or clips, to secure the mesh to the tissue toprovide reinforcement in the repair and structure for encouraging tissueregrowth. The staples or clips are compressed against the tissue andmesh to secure the two together.

One other type of fastener suited for use in affixing mesh to tissue,during procedures such as hernia repair, is a coil fastener having ahelically coiled body portion terminating in a tissue penetrating tip ora hollow screw type fastener having an external thread. Uniqueinstruments have been developed to rotate these fasteners into tissue.Examples of some of these types of surgical fasteners and surgicalinstruments are disclosed in U.S. Pat. Nos. 5,258,000 and 5,830,221, thecontents of which are incorporated by reference herein.

Most surgical instruments for applying fasteners to tissue can beactuated without the distal end of the surgical instrument actually incontact with tissue. This may result in a fastener being inadvertentlyejected prior to placement against tissue or only partially installed intissue.

In hernia repair surgery it is necessary to place multiple fastenersthrough a prosthetic mesh and into tissue. Often it is necessary toactuate the surgical instrument several times to rotate a singlefastener through the mesh and into tissue. This can cause fatigue in theoperator's hand. Additionally, it may be necessary to use a large amountof force on the actuator to install the fastener through variousstiffness meshes resulting in further fatigue to the user's hand.

Thus, there is a need for a surgical instrument which can not beactuated to apply a fastener until the surgical instrument is securelypositioned against the target tissue.

Furthermore, there is also need for a surgical instrument which has apower source to easily and comfortably install multiple fasteners andprovide sufficient torque to drive the fasteners through a prostheticmesh and into tissue.

SUMMARY

There is disclosed a powered tacker device having a handle assembly anda tacker assembly extending distally from the handle assembly. Thehandle assembly includes a power source and a drive assembly mountedwithin the handle assembly. The drive assembly includes a keyed journalrotatably mounted within the handle assembly and rotatable in responseto actuation of the power source. The drive assembly further includes adrive bar longitudinally movable relative to the keyed journal androtatable in response to rotation of the keyed journal. The tackerassembly includes an inner tube terminating in a driver engageable witha fastener contained within the driver. The inner tube is connected tothe rotator and rotatable in response to rotation of the keyed journal.The powered tacker device additionally includes an actuator associatedwith the handle assembly and operable to engage the power source withthe drive assembly.

The keyed journal includes a threaded bore and the drive rod includes athreaded outer surface engageable with the threaded bore. Rotation ofthe keyed journal within the handle assembly moves the drive rod in alongitudinal direction within the handle assembly. The drive bar isconnected to the rotator to move the rotator longitudinally within thehandle assembly in response to rotation of the keyed journal. Keyedjournal further includes distally extending keys. The rotator includesslots engageable with the keys such that the rotator is rotated inresponse to rotation of the keyed journal. In one embodiment, therotator is longitudinally movable along the keys.

In one embodiment, the handle assembly includes a first limit switch anda second limit switch. The first and second limit switches are operableto deactivate the power source from the drive assembly. The drive rodincludes a contact assembly which is engageable with the first limitswitch when the drive bar is in a proximal most position and engageablewith the second limit switch when the drive bar is in a distal mostposition. The handle assembly includes at least one indicator providinga visual indication when the contact assembly has engaged one of thelimit switches.

In one embodiment, the power source includes a motor engageable with thekeyed journal so as to rotate the keyed journal and a battery to powerthe motor. The drive assembly includes a drive gear engageable with thekeyed journal to rotate the keyed journal. The drive gear is engageablewith a spur gear on the motor to rotate the keyed journal.

In one embodiment, the drive assembly includes a mesh gear engageablewith the keyed journal and the drive gear. The drive assembly includes aspring to bias the mesh gear into engagement with the keyed journal. Thespring allows the mesh gear to disengage from the drive gear to preventover rotation of the keyed journal.

The handle assembly includes a safety mechanism preventing actuation ofthe power source prior to the proper positioning of the powered tackerdevice relative to tissue. The safety mechanism includes an outer tubemounted for longitudinal movement relative to the handle assembly and asafety switch actuable in response to movement of the outer tube. Thesafety switch prevents actuation of the power source when the outer tubeis in the distal most position.

There is also disclosed a powered tacker device having a handle assemblyand a tacker assembly extending distally from the handle assembly. Thehandle assembly includes a power source in the drive assembly mountedfor rotation within the handle assembly and rotatable in response toactivation of the power source. The tacker assembly includes an innertube containing a plurality of surgical fasteners and connected to thedrive assembly. A driver is mounted on the distal end of the in the tubeto rotate the surgical fasteners into tissue. The inner tube isrotatable a limited predetermined initial amount relative to the driver.The tacker assembly includes a spring positioned intermediate the innertwo and driver to bias the inner tube relative to the driver.

In one embodiment, the inner tube includes a longitudinally extendingtransfer bar is configured to maintain the surgical fasteners in apredetermined orientation. The driver includes tabs engageable with thesurgical fasteners to drive the surgical fasteners into tissue. Theinner tube is rotatable relative to the driver to move the transfer barinto and out of alignment with the drive tabs. This allows only onefastener at a time to be positioned within the driver while the driverdrives the faster into tissue. Once the transfer bars have beenrealigned with the drive tabs a subsequent fastener may be advanced fromwithin the inner tube and into the driver.

DESCRIPTION OF THE DRAWINGS

An embodiment of the presently disclosed powered tacker device isdescribed herein with reference to the drawings, wherein:

FIG. 1 is a perspective view of a powered tacker device with an outertube separated;

FIG. 2 is a perspective view of a handle assembly of the powered tackerdevice with half of a handle housing removed;

FIG. 3 is a side view of the handle assembly with half of the handlehousing removed;

FIG. 4 is a perspective view, with parts separated, of the poweredtacker device;

FIG. 5 is a perspective view, with parts separated, of the handleassembly;

FIG. 6 is a perspective view, with parts separated, of a distal tackerassembly of the powered tacker device;

FIG. 7 is a perspective view, with parts separated, of componentscontained within a nose cone portion of the handle assembly;

FIG. 7 a is a perspective, partial exploded view of a portion of thepowered tacker device including a spring retainer;

FIG. 8 is a perspective view, with parts separated, of distal endcomponents of the distal tacker assembly;

FIG. 8 a is a perspective view of a driver;

FIG. 9 is a perspective view, with parts separated, of fasteners and abiasing spring assembly associated with a central portion of the distaltacker assembly;

FIG. 10 is a side view, shown in section, of the powered tacker device;

FIG. 11 is a partial side view, shown in section, of the handle assemblyprior to actuation;

FIG. 12 is an enlarged side view, shown in section, of the distalportion of the distal tacker assembly immediately prior to use;

FIG. 13 is an enlarged side view, shown in section, of the distalportion of the distal tacker assembly being urged against prostheticmesh and tissue;

FIG. 14 is a partial side view, with half the handle housing removed, ofthe handle assembly during actuation of a safety mechanism;

FIG. 15 is a partial side view, shown in section, of the handle assemblyduring an initial actuation;

FIG. 16 is a partial side view, shown in section, of the handle assemblyin the actuated position;

FIG. 17 is an enlarged side view, shown in section, of the distalportion of the distal tacker assembly during actuation to install asurgical fastener through prosthetic mesh and into tissue;

FIG. 18 is an enlarged perspective view of a distal portion of thepowered tacker device in accordance with an embodiment of the presentdisclosure;

FIG. 19 is an enlarged perspective view of the powered tacker device ofFIG. 18 illustrated without the outer tube;

FIG. 20 is a cross-section view of the distal portion of the poweredtacker of FIG. 19;

FIG. 21 is an enlarged perspective view of a distal portion of a needleof the powered tacker device in accordance with an embodiment of thepresent disclosure;

FIG. 22 in an enlarged perspective view of a distal portion of theneedle of the powered tacker device in accordance with an embodiment ofthe present disclosure;

FIG. 23 is an enlarged perspective view of a distal portion of thepowered tacker device in accordance with an embodiment of the presentdisclosure; and

FIGS. 24 and 25 are enlarged cross-sectional views of a distal portionof the powered tacker device in accordance with an embodiment of thepresent disclosure.

DETAILED DESCRIPTION OF EMBODIMENTS

An embodiment of the presently disclosed powered tacker device will nowbe described in detail with reference to the drawings wherein likenumerals designate identical or corresponding elements in each of theseveral views. As is common in the art, the term “proximal” refers tothat part or component closer to the user or operator, i.e. surgeon orphysician, while the term “distal” refers to that part or componentfurther away from the user.

Referring to FIG. 1, there is disclosed a powered tacking instrument, orpowered tacker 10, for use in installing surgical fasteners in tissue.Powered tacker 10 generally includes a handle assembly 12 and anelongate distal tacker assembly 14 extending distally from handleassembly 12. Handle assembly 12 includes a handle housing 16 which isformed from two housing halves 16 a and 16 b. Handle housing 16 has agrip portion 18, a body portion 20 and a nose cone portion 22 extendingdistally from body portion 20. Handle assembly 12 has a motor 24,mounted in body portion 20, which powers powered tacker 10 to drivesurgical fasteners into tissue. A trigger 26 is mounted in body portion20 to actuate motor 24 in a manner described in more detail hereinbelow.Handle assembly 12 may also include an indicator or light assembly 28,which is provided to indicate the status of the various cycles and/oroperational status of powered tacker 10. It is also envisioned that aswitch 27 (e.g., a push-button switch in FIG. 1) may be used to turnpowered tacker 10 on and off.

Distal tacker assembly 14 includes an outer tube 30 which is mounted formovement relative to handle assembly 12. Specifically, a proximal end 32is movably mounted through an open distal end 34 of nose cone portion22. Engagement of a distal end 36 of outer tube 30 with tissue movesouter tube 30 relative to handle assembly 12 to activate a lockout orsafety mechanism as described hereinbelow. An inner tube 38 ispositioned within outer tube 30 and also extends distally from handleassembly 12. A driver 40 is positioned on a distal end 42 of inner tube38 such that driver 40 can be rotated by inner tube 38 in response toactivation of powered tacker 10. A torsion spring 44 is connected to,and positioned between, a proximal end 46 of driver 40 and a distal end42 of inner tube 38 to allow driver to have a limited amount ofreversible rotation relative to inner tube 38. This limited amount ofreversible rotation assists in managing the advancement of a fastener 50from inner tube 38 into driver 40, out a distal end 52 of driver 40, andinto tissue.

Referring now to FIGS. 2 and 3, as noted above, handle assembly 12includes a motor 24 which is provided to rotate and advance inner tube38 in response to actuation of trigger 26 in order to install a surgicalfastener into tissue. Handle assembly 12 includes a battery 54 topowered motor 24. A trigger switch 56 is provided on grip portion 18 andis actuated by trigger 26 in order to operate motor 24. Trigger switch56 may be a multiposition type switch allowing actuation of motor 24 inboth a forward and reverse direction. Handle assembly 12 additionallyincludes a circuit board 58 which is provided to control the electronicsof powered tacker 10. In addition to managing the flow of current frombattery 54 through trigger switch 56 and to motor 24, circuit board 58additionally acts as the “brain” of powered tacker 10. Circuit board 58receives signals from various safety and motion limiting switches anddisplays the various operational status conditions of powered tacker 10by means of indicator light assembly 28.

As noted hereinabove, inner tube 38 is rotatably mounted to handleassembly 12 so as to drive a surgical fastener into tissue. Handleassembly 12 contains a drive assembly 60 which is rotatably mountedwithin handle assembly 12. Drive assembly 60 rotates, as well as moveslongitudinally, inner tube 38 in response to actuation of trigger 26.Drive assembly 60 is rotatably mounted on first and second housingflanges 62 and 64 formed in handle housing halves 16 a and 16 b.Specifically, drive assembly 60 includes a distal journal 66 which isrotatably mounted in first housing flange 62 and a proximal journal 68which is rotatably mounted within second housing flange 64. In order torotate drive assembly 60, drive assembly 60 includes a drive gear 70which is engageable with a worm gear 72 provided on motor 24.

In order to ensure that inner tube 38 rotates and translates withinpredetermined parameters, handle assembly 12 includes a proximal limitswitch 74 and a distal limit switch 76. Limit switches 74 and 76 areelectronically connected to motor 24 through circuit board 58. It shouldbe noted that, while not specifically shown, the various electroniccomponents of powered tacker 10 are wired or connected in known mannerto achieve the various switching and display functions. Proximal limitswitch 74 corresponds to the initial or unactuated condition of poweredtacker 10 while distal limit switch 76 corresponds to the fully actuatedcondition of powered tacker 10. A contact arm 78 is associated withdrive assembly 60 to engage proximal and distal limit switches 74 and76.

Powered tacker 10 is provided with a safety mechanism or electroniclockout 80 which prevents actuation of powered tacker 10 when poweredtacker 10 has not been correctly positioned against tissue.Specifically, electronic lockout 80 prevents actuation of powered tacker10 until such time as outer tube 30 has been pressed against tissue andmoved proximately a predetermined distance relative to handle assembly12. At least one safety switch 82 (a pair of safety switches 82 a areillustrated in FIG. 4) may be provided within handle housing 12. It isenvisioned that powered tacker 10 cannot be actuated until at least onesafety switch 82 has been activated to indicate that outer tube 30 hasbeen moved proximately a predetermined amount. Further, it is envisionedthat for powered tacker 10 to be activated, at least one safety switch82 is activated, then outer tube 30 travels from the end of the strokeuntil contact arm 78 contacts distal limit switch 76. Upon release ofpressure on outer tube 30, contact arm 78 retracts until proximal limitswitch 74 is activated, indicating powered tacker 10 is in its originalposition.

Electronic lockout 80 includes a first doglegged arm 84 (FIG. 4) and asecond doglegged arm 86. Doglegged arms 84 and 86 are supported forlongitudinal movement within handle housing 16 by mounting brackets 88.Electronic lockout 80 further includes a base block (FIG. 6 illustratesblock halves 90 a and 90 b) which is engageable with proximal end 32 ofouter tube 30, as well as doglegged arms 84 and 86, to actuate safetyswitches 82 a and 82 b. Base block may be formed as first and secondblock halves 90 a and 90 b which clamp about outer tube 30 in the mannerdescribed hereinbelow. Thus, proximal movement of outer tube 30 relativeto handle housing 12 actuates safety switches 82 a and 82 b to permitoperation of powered tacker 10.

As noted hereinabove, handle assembly 12 includes an indicator lightassembly 28 which is provided to indicate the various operationalconditions of powered tacker 10. Indicator light assembly 28 includesfour lights provided on body portion 20 of handle housing 16. In thisembodiment, the four lights comprise first, second, third, and fourthLED type indicator lights 92, 94, 96 and 98 respectively. Firstindicator light 92 is green and corresponds to the condition where outertube 30 has been moved proximately to actuate safety switches 82 a and82 b. Second indicator light 94 is red and corresponds to the conditionwhere outer tube 30 is in the initial distal most position prior toengagement with tissue and thus actuation on safety switches 82 a and 82b. Likewise, third indicator light 96 corresponds to the initialposition of drive assembly 60 where proximal limit switch 74 has beenactuated and fourth indicator light 98 corresponds to the final positionof drive assembly 60 where distal limit switch 76 has been actuated. Inthis manner, the operational status and condition of powered tacker 10at any point during a surgical procedure is visually indicated to theuser.

Referring now to FIGS. 4 and 5, the various components of drive assembly60 will now be described. Drive assembly 60 generally includes a keyedjournal 100 having a central flange 102. Keyed journal 100 includes adistal hub 104 extending distally from central flange 102. A pair oflongitudinally extending distal keys 106 a and 106 b extend distallyfrom distal hub 104. Distal keys 106 a and 106 b are provided to rotateinner tube 38 as well as allow inner tube 38 to move longitudinally askeyed journal 100 is rotated. Keyed journal 100 additionally includes aproximal hub 108. Keyed journal 100 is rotatably mounted within handlehousing 16. Distal hub 104 is rotatably supported within distal journal66 while proximal hub 108 is rotatably supported within proximal journal68. Keyed journal 100 additionally includes a threaded throughbore 110which enables keyed journal 100 to be rotated within handle assembly 12.

A biasing spring 112 is mounted about proximal hub 108 and is providedto urge a mesh gear 114 into engagement with drive gear 70. Mesh gear114 includes a key 116 which is configured to engage a longitudinallyextending slot (not shown) formed in proximal hub 108. In order toengage mesh gear 114 with drive gear 70, mesh gear 114 includes aplurality of teeth 118 which are engageable with distal teeth 120 formedon drive gear 70. The provision of key 116 within the longitudinallyextending slot formed in proximal hub 108 allows mesh gear 114 to rotatekeyed journal 100 while at the same time allowing for a limited amountof longitudinal movement of mesh gear 114 relative to keyed journal 100against the bias of biasing spring 112. Thus, mesh gear 114 may moveinto and out of engagement with drive gear 70 against the bias ofbiasing spring 112. This provides protection against a surgical fastenerfrom being over rotated into tissue due to excessive torque provided bydrive gear 70 to mesh gear 114.

A C-clip 124 is provided within a proximal groove 126 formed in proximalhub 108 in order to retain biasing spring 112, mesh gear 114 and drivegear 70 on proximal hub 108.

As noted hereinabove, the degree and direction of rotation of inner tube38 is controlled and limited by proximal and distal limit switches 74and 76. Limit switches 74 and 76 are turned on and turned off byengagement with contact arm 78. A contact assembly 128 is provided oncontact arm 78 to engage limit switches 74 and 76. Contact arms 78 andcontact assembly 128 are part of a limit drive bar 130. Limit drive bar130 is a part of drive assembly 60 and, in addition to moving contactassembly 128 between limit switches 74 and 76, converts rotary motion ofkeyed journal 100 into longitudinal motion of inner tube 38 relative tohandle assembly 12. Limit drive bar 130 includes a threaded distalsurface 132 which is engageable with threaded throughbore 110 of keyedjournal 100. Thus, as keyed journal 100 is rotated about limit drive bar130, limit drive bar 130 is moved longitudinally in the distal andproximal directions relative to handle assembly 12.

As shown, contact assembly 128 includes a plate 134 having a pin 136which is engageable with limit switches 74 and 76. Plate 134 is affixedby means of a screw 138 to a proximal end 140 of contact arm 78. Limitdrive bar 130 additionally includes a throughbore 142 for passage of aneedle associated with powered tacker 10 as described in more detailhereinbelow. Limit drive bar 130 further includes a generally round,distally extending circumferential projection 144 which is provided tomove inner tube 38 longitudinally in response to longitudinal motion oflimit drive bar 130 as well as allowing inner tube 38 to rotate relativeto limit drive bar 130.

In order to transfer the rotational motion of keyed journal 100 and thelongitudinal motion of limit drive bar 130 to inner tube 38, driveassembly 60 is provided with a rotator 146. Rotator 146 includes a pairof side slots 148 a and 148 b which are configured to engage and movealong distal keys 106 a and 106 b of keyed journal 100. Additionally,the engagement of distal keys 106 a and 106 b with side slots 148 a and148 b allows keyed journal 100 to rotate rotator 146. Rotator 146includes a proximal slot 150 for receipt of circumferential projection144 of limit drive bar 130. Circumferential projection 144 is free torotate within proximal slot 150 so that limit drive bar 130 can moverotator 146 longitudinally within handle assembly 12 and still allowrotator 146 to rotate in response to rotation of keyed journal 100.

Rotator 146 includes a center hole 152 for receipt of proximal end 48 ofinner tube 38. A pin 154 secures rotator 146 to inner tube 38.Specifically, rotator 146 includes a side hole 158 while proximal end 48of inner tube 38 includes a side hole 158 for receipt of pin 154therethrough. Pin 154 additionally includes a pin hole 160 receipttherethrough of a needle as described in more detail hereinbelow. (Seealso FIG. 7).

As noted hereinabove, electric lockout 80 includes a pair of first andsecond doglegged arms 84 and 86. Doglegged aims 84 and 86 includerespective proximal ends 162 and 164 which are engageable with safetyswitches 82 a and 82 b. Additionally, doglegged arms 84 and 86 includerespective distal ends 166 and 168 which are configured to engage baseblock 90. In order to bias base block 90, and thus outer tube 30 in aninitial distal direction, electronic lockout 80 includes a biasingspring 170 having a proximal spring guide 172. Biasing spring 170 ispositioned between spring guide 172 and base block 90. A bushing 174supports spring guide 172 within handle housing 16. Thus, as outer tube30 is moved proximally against the bias of biasing spring 170, proximalends 162 and 164 of doglegged arms 84 and 86 engage safety switches 82 aand 82 b to allow powered tacker 10 to be actuated.

Referring now to FIGS. 4 and 6, the details of distal tacker assembly 14will now be described. As noted hereinabove, outer tube 30 is mountedfor longitudinal movement relative to handle assembly 12. Outer tube 30includes a longitudinal slot 176 near proximal end 32 for engagementwith base block 90 as described in more detail hereinbelow (see FIG. 7).A plurality of circumferential crenellations 178 are formed all ondistal end 36 of the outer tube 30. Crenellations 178 assist in securinga prosthetic mesh in position against tissue and preventing theprosthetic mesh from rotating as powered tacker 10 rotates fastener 50therethrough.

Distal tacker assembly 14 further includes a bottom guide 180 which isprovided to facilitate the transfer is of fasteners 50 from within innertube 38 and into driver 42 a position to be engaged with driver 40. Afriction ring 182 is provided on driver 40 and is configured to engagean interior of outer tube 30 to allow inner tubes 38 to initially rotatea predetermined distance prior to rotating driver 40 in a mannerdescribed in more detail hereinbelow.

As noted hereinabove, distal tacker assembly 14 contains a plurality offasteners 50. Fasteners 50 are contained within an interior of innertube 38 which acts as a fastener cartridge. In order to move theplurality of fasteners 50 towards driver 40, a spring 184 is providedwithin an interior of inner tube 38. A distal spring guide 186 isprovided between spring 184 and fasteners 50 and a proximal spring guide188 is provided between spring 184 and proximal end 48 of inner tube 38.

As indicated hereinabove, powered tacker 10 includes an elongate needle190 which extends from handle assembly 12 through distal tacker assembly14. Needle 190 is provided with a distal penetrating tip 192. Needle 190extends through fasteners 50 in a manner described in more detail below.Penetrating tip 192 is provided to make an initial, or pilot, hole inmesh and/or tissue for installation of fasteners 50. A proximal end 194of needle 90 is affixed to handle housing 12 by means of a bushing 196which has a pin 198 engageable with handle housing halve 16 a. Thus,needle 190 is affixed to, and remains stationary relative to, handleassembly 12.

Referring now to FIG. 6, and as noted hereinabove, proximal end 32 ofouter tube 30 is affixed to base block 90. Specifically, base block 90includes a pair of inward projections 200 b (one inward projection beinghidden from view in FIG. 6) which each engage proximal slot 176 (only asingle slot 176 is visible in FIG. 6) in outer tube 30. Base block 90further includes a circumferential flange formed as two flange halves202 b (one flange half being hidden from view in FIG. 6) which areconfigured to engage in secure biasing spring 170 (FIG. 7) within handleassembly 12. Base block 90 further includes a pair of proximal detents204 a and 204 b which are configured to engage and move distal ends 166and 168 of doglegged arms 84 and 86. In the embodiment illustrated inFIG. 7, side hole 158 of inner tube 38 is disposed on a substantiallyflat portion 49 adjacent proximal end 48 thereof. Flat portion 49 isincluded on both sides of inner tube 38, such that inner tube 38 may beoriented with rotator 146 and locked via pin 154, as discussed above.

With reference to FIG. 7A, a partially exploded view of several elementsillustrated in FIG. 7 is shown. Here, a spring retainer 175 isillustrated in place of spring guide 172 of FIG. 7. It is envisionedthat spring retainer 175 may be used without or in addition to springguide 172 and/or bushing 174. Additionally, outer tube 30 is shownpositioned adjacent spring 170 and covering a portion of inner tube 38.

Referring to FIG. 8, the details of the distal end of distal tackerassembly 14 will now be described. As noted hereinabove, distal tackerassembly 14 is configured to install a surgical fastener 50 into tissue.Surgical fasteners 50 are of the type disclosed in U.S. patentapplication Ser. No. 10/560,879, filed on Dec. 13, 2005, the contents ofwhich are incorporated herein by reference. Fastener 50 includes anouter helical thread 206 for rotation into tissue. Fastener 50additionally includes a throughbore 208 for receipt of tissuepenetrating tip 192 of needle 190. As noted hereinabove, fastener 50 isdriven into tissue by means of driver 40. Thus fastener 50 includes aslotted head to tend which is configured to be engaged by drive tabs 212formed in distal end 52 of driver 40. Driver 40 includes a distalcircumferential groove 214 for receipt of friction ring 182.

Driver 40 is mounted on inner tube 38 by inserting driver 40 overstepped down distal end 42 of inner tube 38. As noted hereinabove, aspring 44 is provided between driver 40 and inner tube 38. Spring 44includes a proximal spring end 216 and a distal spring end 218. Spring44 allows inner tube 38 to rotate an initial predetermined amountrelative to driver 40 against the bias of spring 44. Proximal end 216 ofspring 44 is affixed within a slot 220 in inner tube 38 while a distalend 218 of spring 44 is affixed within a driver slot 222 formed indriver 40. Inner tube 38 is provided with a pair of longitudinallyextending transfer bars 224 which extends substantially along the lengthof inner tube 38. In an initial position, transfer bars 224 are inlongitudinal alignment with drive tabs 212 formed in driver 40. Initialrotation of inner tube 38 relative to driver 40 rotates transfer bars222 out of alignment with drive tabs 212.

As discussed, inner tube 38 is capable of an initial limited amount ofrotation relative to driver 40 before inner tube 38 begins to rotatedriver 40. Inner tube 38 includes a set screw 226 which extends througha hole 228 provided in distal end 42 of inner tube 38. Referring for themoment to FIG. 8A, driver 40 includes an index slot 230 which isconfigured to receive set screw 226 and allow inner tube 38 to rotate apredetermined distance before set screw 226 engages an edge of slot 230to rotate driver 40 along with inner tube 38. This allows driver 40 torotate and install a fastener 50 into tissue while preventing subsequentfasteners 50 from moving along transfer bars 224 and into driver 40.

As noted hereinabove, distal tacker assembly 14 further includes abottom guide 180 which assists in transferring fasteners 50 from innertube 38 and into driver 40. Bottom guide 180 includes a guide rail 232and a guide pin 234. Bottom guide 180 is mounted within a slot (notshown) formed in driver 40 while guide pin 234 extends through a hole(not shown) formed in proximal end 48 of inner tube 38.

Referring now to FIG. 9, as discussed hereinabove, distal tackerassembly 14 includes spring 184 to bias a plurality of fasteners 50distally within inner tube 38. Distal spring guide 186 includes athroughbore 236 for receipt of needle 190 therethrough. Distal springguide 186 further includes a pair of longitudinally extending slots 238which are configured to ride along transfer bars 224 are formed in innertube 38. A recess 240 is provided in distal spring guide 186 to capturespring 184. Similarly, proximal spring guide 188 includes a throughbore248 and longitudinally extending slots 246. Proximal spring guide 188additionally includes a recess 248 to capture and stabilize spring 184within inner tube 38. Engagement of slots 238 and 246 in distal springguides 186 and 188, respectively, with transfer bars 224 ensure thatfasteners 50 remain in proper alignment to be transferred into driver40.

Referring now to FIGS. 10-18, and initially with regard to FIG. 10, theuse of powered tacker 10 to install surgical fastener 50 throughprosthetic match and into tissue will now be described. In the initialposition, distal end 36 of outer tube 30 is in the distal most positionshielding tissue penetrating tip 92 of needle 90 and fastener 50. Baseblock 90 is also in a distal most position against the bias of spring170. Referring for the moment back to FIG. 2, doglegged arm 86 is alsoin a distal most position remote from the safety switch 82. As notedhereinabove, safety switch 82 prevents actuation of powered tacker 10until outer tube 30 has been properly positioned against tissue.

Trigger 26 is in the unactuated position and contact assembly 128 isengaged with proximal limit switch 74. As noted hereinabove, actuationof proximal limit switch 74 triggers one of the LEDs in indicate lightassembly 28 to signify to the user that powered tacker 10 is ready foruse.

As best shown in FIG. 11, rotator 146 and limit drive bar 130 are in aproximal most position relative to keyed journal 100. In this position,inner tube 38 is also in a proximal most position. As shown in FIG. 12,drive tabs 212 of driver 40 are engaged with slotted head 210 offastener 50.

Referring now to FIG. 13, to attach a prosthetic mesh M to tissue T,distal end 36 of outer tube 30 is urged against mesh M and tissue Tcausing tissue penetrating tip 192 of needle 190 to penetrate throughmesh M and into tissue T. Crenellations 178 provided on distal end 36 ofouter tube 30 secure and stabilize mesh M as fastener 50 is subsequentlyrotated therethrough. As shown, this biases outer tubes 30 proximally inthe direction of arrow A.

As best shown in FIG. 14, as outer tube 30 is biased proximally, outertube 30 moves base block 90 proximally against the bias of spring 170.Proximal movement of base block 90 moves doglegged arm 86, andspecifically proximal end 164 of doglegged arm 86, against safety switch82 b to actuate switch 82 b. Once switch 82 b has been actuated, itsignals circuit board 58 that powered tacker 10 has been properlypositioned and it is safe to actuate powered tacker 10.

Referring now to FIG. 15, once powered tacker 10 has been properlypositioned, trigger 24 may be actuated in the direction of arrow B tocause circuit board 58 to turn on motor 26. Once motor 24 has beenactuated it rotates worm gear 72 which in turn rotates drive gear 70.Rotation of drive gear 70 rotates mesh gear 114 and keyed journal 100 toinitiate rotation and translation of inner tube 38 relative to handleassembly 12. As noted hereinabove, should anything restrict the motionof inner tube 38, mesh gear 114 can compress against the bias of spring112 and thereby disengage distal tacker 14 from handle assembly 12.Rotation of keyed journal 100 causes threaded inner surface 110 to movelimit drive bar 130 in response to engagement of threaded inner surface110 with threads 132 of limit drive bar 130. Engagement of distalprojection 144 of limit drive bar 130 within the slot 150 of rotator 146causes distal longitudinal motion of rotator 146. As rotator 146 movesdistally it moves inner tube 38 distally.

As noted hereinabove, rotation of keyed journal 100 also causes rotationof rotator 146. Additionally, rotator 146 can move longitudinally alongdistal keys 106 of keyed journal 100. Thus, keyed journal 100 serversthe dual purpose of rotating rotator 146, and thus inner tube 38, aswell as allowing for distal motion of rotator 146 relative to keyedjournal 100.

Referring now to FIG. 16, once limit drive bar 130 has been moved to itsdistal most position, contact assembly 128 engages distal limit switch76 to turn off motor at 24 and prevent any over rotation of inner tube38.

As best shown in FIG. 17, full distal movement and rotation of innertube 38 causes driver 40 to advance and rotate fastener 50 throughprosthetic mesh M and into tissue T to thereby secure prosthetic mesh Mto tissue T.

While not specifically shown, once a first fastener 50 has been properlyinstalled, trigger 26 can be moved to reverse the rotation of motor 24.Reverse rotation of motor 24 causes reverse rotation of keyed journal100 thereby moving inner tube 38 proximally to an initial position. Asinner tube 38 is rotated in the reverse direction it causes set screw226 to rotate back through slot 230 in driver 40 an initial position. Inthe initial position, transfer bars 224 are in alignment with drive tabs212 so that a subsequent fastener can be transferred into driver 40.Once inner tube 38 is moved back to its initial position, contactassembly 128 contacts proximal limit switch 76 to indicate to the userpowered tacker 10 is in condition for subsequent use. As powered tacker10 is moved away from tissue, outer tube 30 moves back to a distal mostposition shielding the next subsequent fastener 50 to be installed. Whenouter tube 30 is in the distal most position safety switch 82 isdeactivated preventing powered tacker 10 from operation until outer tube30 has been again properly positioned against tissue and safety switch82 is actuated.

Before pressure is applied to powered tacker 10, transfer bars 224 arein alignment with drive tabs 212 and distal end of fastener 50 iscontacting a retention feature 191 (FIG. 19) on needle 190. Retentionfeature 191 prevents fastener 50 in contact therewith from being pushedoff needle 190 by spring 184. It is envisioned that when safety switch82 is engaged, transfer bars 224 rotate clockwise, such that after theinitial 90 degree rotation of transfer bars 224, transfer bars 224 anddrive tabs 212 are diametrically opposed. It is envisioned that transferbars 224 and drive tabs 212 remain diametrically opposed for theremainder of the stroke. Here, transfer bars 224 may create the forcenecessary to push fastener 50 distally and drive tabs 212 are capable ofmaintaining the frictional fit with head 210 of fastener 50.

Upon completion of the firing stroke, the pressure of powered tacker 10is released and powered tacker 10 moved proximally—away from ejectedfastener 50. Torsion spring 44 may then bring drive tabs 212 back totheir resting position, such that drive tabs 212 are substantiallyaligned with transfer bars 224. Once drive tabs 212 and transfer bars224 are aligned, spring 184 pushes the next fastener 50 distally untildistal portion of fastener 50 contacts retention feature 191 of needle.

An embodiment of the present disclosure is illustrated in FIGS. 18-20.In this embodiment, inner tube 38 includes at least one tab 302 (twotabs 302 are shown in FIG. 20) and needle 190 includes a retentionfeature 191 (FIG. 19) proximal of distal penetrating tip 192. Retentionfeature 191 opposes the force exerted by spring 184, such that fastener50 does not prematurely become ejected from powered tacker 10. To forcefastener 50 past retention feature 191, tabs 302 on inner tube 38 aredeflected inwardly such that tabs 302 are disposed proximal ofdistal-most fastener 50 (see FIG. 20) and inner tube 38 is moveddistally. Thus, tabs 302 of inner tube 38 contact a proximal portion offastener 50 and force fastener to move past retention feature 191 anddistally toward tissue. It is envisioned that tabs 302 are biasedinwardly. It is also envisioned that tabs 302 are deflected inwardlyafter contacting a fluted section (not explicitly shown in thisembodiment) of outer tube 30 (FIG. 18).

Other embodiments of the present disclosure are illustrated in FIGS. 21and 22. FIG. 21 illustrates needle 190 having a cut-out portion 350 anda rod 360, and FIG. 22 illustrates needle 190 having a channel 354 androd 360. In both embodiments, rod 360 includes a protrusion 362 adjacentits distal end and is secured to needle 190 adjacent its proximal end(e.g., via a weld). It is envisioned that rod 360 is cantilevered andits distal end is biased away from needle 190. Fastener 50 (e.g.,distal-most fastener) is shown in FIG. 21 around a portion of needle190. Protrusion 362 opposes the force exerted by spring 184 (FIG. 6),such that fastener 50 does not prematurely become ejected from poweredtacker 10. To force fastener 50 past protrusion 362, rod 360 isdeflected against the biasing force (e.g., downwardly in FIGS. 21 and22) by exerting additional force on fastener 50, such that protrusion362 is able to pass through throughbore 208 of fastener 50. Afterfastener 50 passes rod 360, rod 360 returns to its original biasedposition as the distal end of rod 360, including protrusion 362, springsaway from needle 190 and is thus in a position to maintain a subsequentfastener 50 on needle 190.

FIGS. 23-25 illustrate additional embodiments of the present disclosure.In these embodiments, a plate 370 is illustrated adjacent distal end 42of inner tube 38. Plate 370 is shown with a plate groove 372 adjacentits distal end and plate groove 372 is configured to accept a plate ring374 therein. Further, a needle ring 380 is shown in FIG. 23 and isdisposed within a needle groove (hidden from view in FIG. 23). It isenvisioned that the needle groove is dimensioned to allow needle ring380 to be at least partially compressed therein in response to asufficient amount of force exerted against needle ring 380. Therefore,needle ring 380 and the needle groove combine to maintain distal-mostfastener 50 on needle 190 until an additional force is exerted onfastener 50 to compress needle ring 380 and push fastener 50 over anddistally past needle ring 380, thus ejecting distal-most fastener 50from needle 190.

Referring more specifically to FIGS. 24 and 25, enlarged,cross-sectional views of distal end 42 of inner tube 38 are illustratedincluding plate 370 thereon. Plate 370 is shown including two halves 370a and 370 b, but is also envisioned that plate 370 may be a single partthat is disposed around needle 190 and/or at least partially withininner tube 38. It is envisioned that a proximal portion of each platehalf 370 a, 370 b is secured to inner tube 38, and a distal portion ofeach plate half 370 a, 370 b is floating, or otherwise unsecured, inrelation to inner tube 38. Plate ring 374 encircles plates 370 a, 370 bwithin plate groove 372 and confines outward movement of plates 370 a,370 b. It is also envisioned that plate ring 374 inwardly biases eachplate half 370 a, 370 b, as illustrated in FIG. 24. Here, plate lips 376a, 376 b are disposed proximal of head 210 of distal-most fastener 50,thus restricting proximal translation of distal-most fastener 50.

With reference to FIG. 25, upon distal movement of fastener 50 heldadjacent plates 370 a, 370 b, fastener 50 forces distal portion ofplates 370 a, 370 b outward in the direction of arrows C and D (withinthe confines of plate ring 374). Plates 370 a, 370 b are moved outwardfar enough to allow fastener 50 to pass therethrough and be ejected fromneedle 190. A ramp 378 may also be included on inner surface of eachplate 370 a, 370 b to facilitate fastener 50 passing therethrough.

It will be understood that various modifications may be made to theembodiments disclosed herein. For example, the disclosed powered tackerdevices may be provided with an AC type power source which is notself-contained within the powered tacker device. Further, the disclosedcircuit board may be configured to automatically rotate the motor in thereverse direction to reset the powered tacker devices after a surgicalfastener has been installed in tissue. Additionally, various othermechanisms of transferring individual fastener is from within acartridge assembly to a driver are contemplated herein. Yet stillfurther, the disclosed powered tacker devices may be configured so thatthe distal tacker assembly is removable, and or disposable, from theassociated handle assembly. Therefore, the above description should notbe construed as limiting, but merely as exemplifications of particularembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the claims appended hereto.

1. A powered tacker device comprising: a handle assembly having a powersource and a drive assembly mounted within the handle assembly, thedrive assembly including a keyed journal having a threaded boreextending therethrough, the keyed journal being rotatably mounted withinthe handle assembly and rotatable in response to actuation of the powersource, a drive bar longitudinally movable at least partially throughthe keyed journal and a rotator rotatable in response to rotation of thekeyed journal, the drive bar defining a longitudinal axis and includinga threaded outer surface engageable with the threaded bore such thatrotation of the keyed journal moves the drive bar in a longitudinaldirection within the handle assembly; an actuator associated with thehandle assembly and operable to engage the power source with the driveassembly; and a tacker assembly extending distally from the handleassembly and being substantially aligned with the longitudinal axis, thetacker assembly containing a plurality of surgical fasteners, the tackerassembly including an inner tube terminating in a driver engageable withthe fasteners, wherein the inner tube is connected to the rotator androtatable in response to rotation of the keyed journal; wherein thedrive bar is connected to the rotator to move the rotator longitudinallywithin the handle assembly in response to rotation of the keyed journal;wherein the keyed journal includes at least one distally extending keyand the rotator includes at least one slot engageable with the at leastone key such that the rotator is rotated in response to rotation of thekeyed journal.
 2. The powered tacker device as recited in claim 1,wherein the rotator is longitudinally movable along the at least onekey.
 3. The powered tacker device as recited in claim 1, wherein thehandle assembly includes a first limit switch and a second limit switch,the first and second limit switches operable to deactivate the powersource.
 4. The powered tacker device as recited in claim 3, wherein thedrive bar includes a contact assembly, the contact assembly engageablewith the first limit switch when the drive bar is in a proximal mostposition.
 5. The powered tacker device as recited in claim 3, whereinthe drive bar includes a contact assembly, the contact assemblyengageable with the second limit switch when the drive bar is in adistal most position.
 6. The powered tacker device as recited in claim4, wherein the handle assembly includes at least one indicator, theindicator providing a visual indication when the contact assembly hasengaged the first limit switch.
 7. The powered tacker device as recitedin claim 6, wherein the handle assembly includes at least one indicator,the indicator providing a visual indication when the contact assemblyhas engaged the second limit switch.
 8. The powered tacker device asrecited in claim 1, wherein the handle assembly includes a safetymechanism, the safety mechanism preventing actuation of the power sourcein response to the position of an outer tube associated with the tackerassembly.
 9. The powered tacker device as recited in claim 8, whereinthe safety mechanism includes a safety switch actuable in response tomovement of the outer tube, the safety switch preventing actuation ofthe power source when the outer tube is in a distal most position.
 10. Apowered tacker device comprising: a handle assembly having a powersource and a drive assembly mounted within the handle assembly, thedrive assembly including a keyed journal having a bore extendingtherethrough, the keyed journal being rotatably mounted within thehandle assembly and rotatable in response to actuation of the powersource, a drive bar longitudinally movable at least partially throughthe keyed journal and a rotator rotatable in response to rotation of thekeyed journal, the drive bar defining a longitudinal axis; an actuatorassociated with the handle assembly and operable to engage the powersource with the drive assembly; and a tacker assembly extending distallyfrom the handle assembly and being substantially aligned with thelongitudinal axis, the tacker assembly containing a plurality ofsurgical fasteners, the tacker assembly including an inner tubeterminating in a driver engageable with the fasteners, wherein the innertube is connected to the rotator and rotatable in response to rotationof the keyed journal; wherein the power source includes a motorengageable with the keyed journal to rotate the keyed journal and abattery to power the motor; wherein the drive assembly includes a drivegear engageable with the keyed journal, the drive gear engageable with aspur gear on the motor to rotate the keyed journal; wherein the driveassembly includes a mesh gear engageable with the keyed journal and thedrive gear; wherein the drive assembly includes a spring positionedwithin the keyed journal, the spring biasing the mesh gear intoengagement with the drive gear.
 11. The powered tacker device as recitedin claim 10, wherein the handle assembly includes a safety mechanism,the safety mechanism preventing actuation of the power source inresponse to the position of an outer tube associated with the tackerassembly.
 12. The powered tacker device as recited in claim 11, whereinthe safety mechanism includes a safety switch actuable in response tomovement of the outer tube, the safety switch preventing actuation ofthe power source when the outer tube is in a distal most position. 13.The powered tacker device as recited in claim 10, wherein the handleassembly includes a first limit switch and a second limit switch, thefirst and second limit switches operable to deactivate the power source.14. The powered tacker device as recited in claim 13, wherein the drivebar includes a contact assembly, the contact assembly engageable withthe first limit switch when the drive bar is in a proximal mostposition.
 15. The powered tacker device as recited in claim 14, whereinthe handle assembly includes at least one indicator, the indicatorproviding a visual indication when the contact assembly has engaged thefirst limit switch.
 16. The powered tacker device as recited in claim13, wherein the drive bar includes a contact assembly, the contactassembly engageable with the second limit switch when the drive bar isin a distal most position.
 17. The powered tacker device as recited inclaim 16, wherein the handle assembly includes at least one indicator,the indicator providing a visual indication when the contact assemblyhas engaged the second limit switch.